Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line • <br /> CD Z. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal StructureQO $ Addition/Alteration to Dwelling/Principal Structure $200 k <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> XAccessory Structure(Garage,Shed,etc.)09 $3 Q Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 << , <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 • <br /> ` <br /> Filling/Grading $150 Boathouse $500 <br /> cn I, <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 2. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. i . <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 2, <br /> Z <br /> 7.:. —.....\5) <br /> Property Owner's Name: -g 00 f A' (k —" -iyn C,,__ i. (a (\ 5- <br /> 0 w <br /> a�g1- 19 Y v� QS(=-c do, u�I )q0 Property Owner's Mailing Address: \ n <br /> L 0 O r\ Ci State Zip "' <br /> Property Site Address: 1`� ) `�t r WI o <br /> CD <br /> Contact's Telephone Number: —6 0 9_ '7cO 0a <br /> 80 /� /; N d Ilk <br /> Contact's Email: (Ll�,U, &"LOI tipTtkoo. C t I 0b <br /> **If staff has a question about this application,you will be acted via email. Make sure your email address is N -e <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °o °Q <br /> @BurnettCountyWLgov / (.' } /+ d <br /> Legal Description of Property: . f' C. -TN Lid I Li 1-L0 \/o� NUJ tX CSiY g,. j <br /> / U g 1 1� �l�t\\ouk, L V J �3r � �� <br /> Section#: (� Town #: N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax sy em property page.* W 0 f H <br /> Tax ID#(1-5 digit number; found on tax statement): 314 55 5� d <br /> Proposed Use of Structure/Addition: /v ,(' -.l✓A <br /> Anticipated Start Date: r 4 (Home/Cabin;Comm /ial Business•Bedr m;Deck;etc.) ^ \}1 <br /> � / i O <br /> Building Contractor: v l <br /> Sewer Installer: 'V 1 F-ic ,,D <br /> z r <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> s k.,a ,,,cLs 0,, -vv,, c)c-09.-e(--.)-lUQ11(\-E__V V kk)-C- <br /> ( C_ i ►( L Q . Sv`_ec ► c o„ 1 oc ( . S 4 Fee Rec: 3y <br /> vl O •Mee'MeekcUJ- s.t4 t.J s • ACLes5 art( S-En kL-kWt y. <br /> '1 (� a.0 - nod- -� be uud .Cor hkk ylkan hGtaO i-1-a-}-t OOnm° Check#: I.GL� <br /> CO/VA ` s <br /> •?c -k P -to iv_ re moved by 1013012023 <br /> o <br /> rn <br /> Date of staff site visit: /Ai Initials of site visit staff: < r Innl <br /> /26/2 <br /> m c. uu uAPPROVED BY LAND SERVICES OFFICIALATE: 002 3 rn 0l^ D <br /> y (D C <br /> a < 3 z <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z y w �_ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT X w Z w <br /> Page l of 5 Il! <br /> Burnett County, WI Land Use Application—Rev 12/2022 0 J <br /> a <br />